use of antimicrobial drugs – limitations and ... health/chapman...md senate bill 471 – miad law...
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UPDATE ON IMPLEMENTATION OF NEW MARYLAND LAW SB471USE OF ANTIMICROBIAL DRUGS – LIMITATIONS AND REPORTING REQUIREMENTS
NJ CHAPMAN DVM MPH NEUSAHA DISTRICT MEETING OCTOBER 29, 2019
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WILL REVIEW….
SB471 Summary & Deadlines
Medically Important Antibiotic Use Reporting Requirements - Progress Report
Blanket vs. Select Dry Cow Treatment Restrictions - Progress Report on BMPs
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MD SENATE BILL 471 –MIAD LAW
Prohibits use of medically important antimicrobial drugs (MIAD) “in a regular pattern” by feed or water in large cattle, swine and poultry operations and requires vet evalfor RX or VFD by January 1, 2018.
Requires submission by veterinarians of copy of VFD or RX for MIAD in feed or water for large cattle, swine & poultry operations beginning January 1, 2020
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ELEVATED RISK REQUIRED FOR PROPHYLACTIC USE
“Elevated risk” means
a risk that is significantly higher than that present under normal or standard operating conditions, and
does not include a risk typically or frequently present under normal or standard operating conditions
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VFD SUBMISSION & REPORTING
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VFD SUBMISSION & REPORTING
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DRY COW LAW
Prohibits blanket treatment of dairy cows at dry-off using medically important antimicrobial drugs by January 1, 2021 Must have assessment of the presence of an intra-mammary infection
to treat with MIADs (does not specify by veterinarian)
MIAD may be administered if veterinarian judges the MIAD is “necessary for prophylaxis to address an elevated risk of contraction of a particular disease or infection”….
unclear in law if blanket treatment is allowed under this stipulation
Farms with fewer than 300 cattle are exempt
WORKING GROUP SET UP WITH GOAL: REACH CONSENSUS ON REGULATIONS TO IMPLEMENT SELECTIVE DRY COW
TREATMENT REQUIREMENT UNDER SB471
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DRY COW THERAPY
Dry cows are at ↑ risk of mastitis Fewer management
techniques
Immune suppression
Subclinical mastitis in dry cows leads to ↑clinical mastitis
↑ SCC in next lactation
http://www2.ca.uky.edu/agcomm/pubs/ID/ID209/ID209.pdf
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CURRENT DRY COW ANTIBIOTIC USAGE
80.3
8.86.6 8
90.8
33.9
0.8 0.7 2.5
36.9
12.7
0.6 0.7 1.9
14
0
10
20
30
40
50
60
70
80
90
100
Blanket Treatment
SCC Mastitis History
Other Total operations
Perc
enta
ge o
f Ope
rati
ons
Type of Treatment
IMM antimicrobial
Internal teat sealant
External teat sealant
USDA APHIS, 2016
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DESIGN THAT FAILED
“SDCT” GroupQuarters not treated
BDCT GroupAll quarters treated
Tracked from calving to 100 days in milk (DIM)
97 Dutch herds; 1,657 low SCC cows(L1 < 150,000 SCC, L2+ < 250,000 SCC)
- Split udder design: Randomly assign quarters
From Godden, Royster, Timmerman, and Patel, College of Veterinary Medicine, University of Minnesota
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Results BDCT SDCT P value
Prevalence of IMI at calving 38% 49% < 0.01
Clinical mastitis (cases/qtr day at risk) 0.24 x 10-3 0.41 x 10-3 < 0.0001
SCC at 14 DIM (median) 30,000 40,000 < 0.01
Drug use at dry off (dose/animal) 3,314 0
All antibiotic drug use by100 DIM 3,692 542
Why?
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WHY DID SELECT TREATMENT FAIL?
Conclusion: SDCT reduced drug use but resulted in more clinical mastitis and ↑SCC
Why did this SDCT program fail?1) Insensitive diagnostic test (SCC) (did not identify subclinical
cases)2) No teat sealant (did not protect from new infections)3) No modification of environment top protect from mastitis
Scherpenzeel , et al., 2014. JDSci 97
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DESIGNS THAT SUCCEEDED
Sensitive Diagnostic Test
Protect from New Infections
Treat Current Mastitis Cases
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RECOMMENDATIONS
Reduce risk of dry period infections Clean, dry, even bedding in dry-cow yards
Gradual dry-off over 1-2 weeks to <10kg per day Gradually decrease concentrate fed
Decrease number of milkings per day
Dry-cow rations by nutritionist
Individual calving pens
Milk cows within 24h of calving
Proper infusion technique of teat sealant
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RECOMMENDATIONS
Herds with bulk tank SCC <250,000
No contagious mastitis organisms on farm Strep. agalactiae, Staph. aureus, and Mycoplasma primary contagious
pathogens
No introduction of new cows to dry herd
Gram-negative core antigen vaccination
Monitoring outcomes Dairy Herd Improvement Association
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RECOMMENDATIONS
UK’s AHDB Dairy Mastitis Control Plan Formulated for each farm by trained veterinarians Cow housing, including dry cows and heifers
Milking parlour function and milking routine
Management of the dry period
Treatment of mastitis
Other areas such as biosecurity and youngstock management
https://dairy.ahdb.org.uk/technical-services/mastitis-control-plan/#.Wg1rrWi0OUk
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MORE RECOMMENDATIONS!
Cow-level criteria In last three months, individual SCC: <150,000 for cows
<100,000 for heifers
Maximum of one episode of clinical mastitis during current lactation No mastitis in last three months
Negative CMT test at dry-off
Negative milk culture
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MASTITIS TESTSTest Sensitivity Specificity Speed Reference
Cow level
CMT (≥ trace) 70% 48% Rapid (cowside) Sanford et al., 2006
SCC (> 200,000) 70% 51% Rapid (if use DHIA) Torres et al., 2008
On-farm culture 85% 73% 1-2 day turnaround Cameron et al., 2013(Petrifilm system, 3M)
Quarter level
CMT (≥ trace) 61% 80% Rapid (cowside) Middleton et al., 2004
SCC (> 200,000) 57-64% 66-86% 0.5-1 day turnaround Pantoja et al., 2009; Middleton et al., 2004
On-farm culture 92% 52% 1-2 day turnaround Royster et al, 2016(MN Easy™ 4Cast™, UMN)
From Godden, Royster, Timmerman, and Patel, College of Veterinary Medicine, University of Minnesota
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ASSESSMENTS PROPOSED ACCEPTABLE TO INDICATE THE PRESENCE OF AN INTRA-MAMMARY INFECTION
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OR…..VETERINARIAN DIAGNOSIS In California Maryland, the potential use of medically important
antimicrobial drugs (hereafter referred to as antibiotics) in livestock must be deemed necessary under the professional judgment of a California Maryland licensed veterinarian, within the context of a valid veterinarian-client-patient relationship (VCPR) and in accordance with current veterinary medical practice and legal parameters.
To use antibiotics effectively and responsibly, a veterinarian must first develop a preliminary or general diagnosis, or have an indication of elevated risk of disease or infection.
The diagnostic process includes consideration of the history, clinical judgment, and epidemiological knowledge of the veterinarian.
https://www.cdfa.ca.gov/AHFSS/aus/
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HERD ASSESSMENT TO SUPPORT BLANKET DRY COW TREATMENT
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THE ROAD AHEAD…..LESSONS LEARNED
Increase Outreach to Vets, Stakeholders on ABX Use
Consider Requiring Veterinary CEU on ABX Use
Establish an Advisory Group Sooner than Later
Explore Funding Sources to expand support to state Dairy Industry, including promotion of Judicious Use of Antibiotics
COMMENTS/IDEAS/QUESTIONS: [email protected] 410-841-5810